Long-Term Impact of the COVID-19 Pandemic on Self-Management of Chronic Conditions: The C3 Study

COVID-19 大流行对慢性病自我管理的长期影响：C3 研究

基本信息

批准号：
10342940
负责人：
Stacy C Bailey
金额：
$ 68.29万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-06-01 至 2027-03-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10342940
关键词：
Acute Adherence Adult Affect Age Alcohols Anxiety Award Biometry COVID-19 COVID-19 impact COVID-19 pandemic effects COVID-19 stress Caring Cessation of life Chicago Chronic Chronic Disease Cohort Studies Collection Communities Data Data Collection Diet Disease Disease Outbreaks Disease Outcome Elderly Electronic Health Record Ethnic Origin Exhibits Fright Gender Grief reaction Health Health Professional Health Status Health behavior Health system Healthcare Individual Infection Infection prevention Intervention Interview Life Style Long COVID Mediating Medical Mental Depression Mental Health Modernization Monitor New York City Outcome Parents Participant Patient Outcomes Assessments Patients Personal Satisfaction Persons Physical activity Prevalence Preventive Health Services Public Health Race Reporting Research Personnel Risk Factors Role Self Efficacy Self Management Site Sleep Sleep disturbances Social Distance Social isolation Social support Socioeconomic Status Stress Surveys Time Virus Voice Weight Gain authority cohort comorbidity coronavirus disease experience follow up assessment functional status health care service health data health disparity health literacy health management long term consequences of COVID-19 middle age novel pandemic disease physical conditioning physical inactivity psychosocial response sex sex disparity socioeconomics substance use telehealth treatment adherence

项目摘要

ABSTRACT We will extend an active NIA cohort study of diverse, middle age and older adults with ≥1 chronic conditions to assess COVID-19’s long-term and disparate impact on health and healthcare experiences. COVID-19 has become an unprecedented public health threat in modern times, especially for older adults with a chronic illness. As of January 2021, 94% of COVID deaths have been among adults over 55; 92% of those who have died had ≥1 underlying health conditions. Beyond consequences to personal health associated with acquiring COVID-19, the impact of the pandemic may likely extend to non-COVID-19 outcomes as a patient’s ability to self-manage chronic conditions during and after a pandemic may be compromised for several reasons. In March 2020, our team rapidly launched the COVID-19 & Chronic Conditions (C3) study as cases of COVID-19 emerged in the U.S. to assess how adults with ≥1 chronic conditions were responding to the pandemic. Five active studies with uniform data collection on a range of patient-reported outcomes prior to COVID-19 and with electronic health records access were leveraged to establish the C3 cohort; 673 adults in Chicago were interviewed during the 1st week of the outbreak. The cohort was immediately expanded using two of the ‘parent studies’ that also had sites in New York City (n=200; N=873). C3 participants are diverse by socioeconomic status, race, ethnicity, gender, health literacy, and comorbidity. An NIA COVID-19 supplement was awarded in August 2020 to expand the cohort via the parent studies (N=1200) and continue data collection up to 2022; 5 of 7 planned survey waves have been completed (83-94% retention). C3 findings reveal many adults exhibit sustained, high stress due to COVID-19 that impacts lifestyle, treatment adherence, and healthcare use. Disparities by sex, race, ethnicity, and SES also are present. Health professionals and researchers are now voicing concern for possible long-term consequences of COVID-19 on personal health & healthcare. In response, we propose to continue to follow the C3 cohort to capture data 5 years post onset of the U.S. outbreak. All participants will have a ‘Pre-COVID’ baseline and 7+ follow-up assessments to assess trajectories in health care use, patient-reported & chronic disease outcomes. Our primary aims are to: 1) evaluate changes in lifestyle, health behaviors, healthcare use, health status, and chronic disease outcomes from a pre-pandemic baseline through 5 years after onset of COVID-19; 2) determine the extent to which stress, anxiety, and depression contribute to poor health status and chronic disease outcomes through 5 years after the pandemic’s onset. Our secondary aim is to: 3) identify factors that mediate or moderate associations between stress, anxiety, and depression during/after the pandemic with health status and chronic disease outcomes, while our exploratory aim is to: 4) explore whether health disparities by age, sex, race, ethnicity, or socioeconomic status emerge or worsen during/after the pandemic and the contributing role of stress, anxiety, and depression.

抽象的我们将延长一项主动NIA队列研究，对潜水员，中年和老年人，≥1个慢性评估Covid-19的长期和不同影响健康和医疗体验的条件。 Covid-19在现代已成为前所未有的公共卫生威胁，尤其是对于老年人患有慢性病。截至2021年1月，在55岁以上的成年人中，有94％的Vovid死亡人数已有；其中92％死亡的人的健康状况≥1。与与个人健康有关的后果获取Covid-19，大流行的影响可能会扩展到非旋转19的结果，作为患者的结果出于几个原因，可能会损害大流行期间和之后自我管理的慢性病的能力。 2020年3月，我们的团队迅速启动了Covid-19＆慢性病（C3）研究 COVID-19在美国出现，以评估患有≥1种慢性病的成年人如何应对大流行。在一系列患者报告的结果之前，有五项积极的研究与统一的数据收集 COVID-19和具有电子健康记录的访问权限被利用以建立C3队列； 673名成年人在爆发的第一周，芝加哥接受了采访。立即使用两个在纽约市也设有网站的“家长研究”中（n = 200; n = 873）。 C3参与者是潜水员社会经济地位，种族，种族，性别，健康素养和合并症。 NIA COVID-19 于2020年8月授予通过家长研究（n = 1200）扩大队列的授予，并继续数据收集直到2022年； 7个计划的调查浪中有5个已经完成（保留83-94％）。 C3发现揭示了许多成人暴露了持续的高压力，这会影响生活方式，治疗依从性和医疗保健使用。性别，种族，种族和SES的差异也存在。卫生专业人员和研究人员现在正在对Covid-19对个人健康和医疗保健的长期后果可能导致的担忧。作为回应，我们建议继续遵循C3队列，以捕获美国在美国发作后5年的数据。暴发。所有参与者都将进行“前”基线和7次以上的随访评估，以评估轨迹在医疗保健中，患者报告和慢性疾病结果。我们的主要目的是：1）评估更改在生活方式，健康行为，医疗保健使用，健康状况和慢性疾病结局中 Covid-19发作后5年的基线; 2）确定压力，动画和抑郁症导致健康状况不佳和大流行后5年的慢性疾病结局发作。我们的次要目的是：3）确定介导或中度关联的因素，焦虑和大流行期间患有健康状况和慢性疾病结果的抑郁症，而我们探索性目的是：4）探索划分年龄，性别，种族，种族或社会经济状况的健康分配是在大流行期间/之后出现或更糟，压力，焦虑和抑郁症的作用。